Prediction of late-onset fetal growth restriction using a combined first- and second-trimester screening model

Background: Prediction models for early fetal growth restriction (FGR) have been exhibited in many researches. However, prediction models for late FGR are limited. Late-onset FGR is easy to miss clinically because of its insidious onset. This study aimed to develop a simple combined first-and second-trimester prediction model for screening late-onset FGR in fetuses. Methods: This retrospective study included 2746 women who had singleton pregnancies and received routine ultrasound scans as training dataset. Late FGR is that diagnosed >32 weeks. Multivariate logistic regression was used to develop a prediction model. Results: One hundred and twenty-nine fetuses were identified as late-onset FGR. The significant predictors for late-onset FGR were maternal height, weight, and medical history; the first-trimester mean arterial pressure, the second-trimester head circumference/ abdominal circumference ratio; and the second-trimester estimated fetal weight. This model achieved a detection rate (DR. ) of 51.6% for late-onset FGR at a 10% false positive rate (FPR) (area under the curve (AUC): 0.80, 95%CI 0.76-0.84). Conclusions: A multivariate model combining first-and second-trimester default tests can detect 51.6% of cases of late-onset FGR at a 10% FPR. Further studies with more screening markers are needed to improve the detection rate. (c) 2021 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)